As a benefits administrator, you likely have customers asking how you can manage premium billing. It may be for a COBRA population or an association that bills its members for insurance products, or even a religious organization that bills its individual locations.
However, many benefits administrators lack the expertise necessary to manage the complex premium billing these examples present. So when you choose a new partner, it is easy to get lost in the list of features: rules-based engines, automated data sync, digital payment portals.
While the technology is essential, your billing partner is more than just the software they provide. The real value lies in the team behind the technology. The right partner will not only have a great platform but will also offer a strong implementation process, ongoing support, and a deep understanding of your unique needs.
The Implementation: A Blueprint for Success
The initial implementation of a new billing system is a critical period. A bumpy or poorly managed rollout can cause significant business disruption and cost your team valuable time. A great partner will treat this as a collaborative project, not just a software install.
Look for a partner that provides:
- A Dedicated Project Manager: You should have a single point of contact who understands your business goals and can guide you through every step, from data migration to go-live.
- A Phased Rollout Plan: Instead of a risky everything-at-once approach, your partner should propose a clear, phased plan that allows for testing and validation at every stage. This phased approach minimizes disruptions and risk.
- Thorough Training: The best technology is useless without a team that can use it. A good partner will provide comprehensive, hands-on training for your staff to ensure a smooth transition.
If you plan to have many clients transition to the platform, ensure the introduction of repeatable processes to streamline the onboarding process.
The Support: A Partner for the Long Haul
Once the system is live, the true partnership begins. Every billing platform requires continuous support, especially in an industry with constant regulatory changes, evolving plan designs, and complex billing and delinquency rules.
When evaluating a partner, ask about their approach to support:
- Accessibility: Is their support team easily accessible? Do they offer multiple channels for communication, such as a portal, phone, or email?
- Proactive vs. Reactive: Does the partner react to your problems, or do they proactively provide updates, insights, and recommendations to help you optimize the system and your processes?
- Tiered Support: What kind of support does the provider offer after implementation? Can you access an optional tier 2 client support center to help you with the most complex cases?
The Industry Understanding: More Than Just a Vendor
Industry knowledge is where a good partner truly stands apart from a great one. The healthcare and benefits administration industry is complex, with unique regulations, data standards, and business rules. A generic technology vendor will not understand your specific challenges.
A true partner will demonstrate a deep understanding of:
- Regulatory Compliance: They should be experts on relevant industry regulations and ensure their platform maintains compliance.
- Complex Plan Designs: They should have a track record of handling unique and complex scenarios, such as unique billing rules, unusual capabilities (like commission management), and diverse plan structures.
- Your Clients’ Needs: They should understand that the billing experience is part of the overall client journey and create a seamless and user-friendly experience that improves client satisfaction.
The Technology
I know, I know, the title implies a good partner is more than just technology. But you do need to evaluate the technology. Some items to consider:
- Integration Points: How does the solution integrate with the technology you use? Is there single sign-on (SSO)? Can it integrate with upstream systems (like enrollment platforms) and downstream platforms (like general ledgers)?
- Capabilities: What capabilities exist in the solution? Look for solutions that can easily handle complex billing rules, manage communications related to late payments, leverage a wide range of payment options, and include a payment portal so you do not have to roll your own.
- Design: To automate retroactivity and accurately manage complex premium billing rules, you need a system with an accounting-based design. List billing-based systems fail to provide the same level of automation and accuracy as accounting-based systems.
Choosing a premium billing partner is a significant decision. While the technology matters, your partner’s expertise, support, and collaborative approach are what will truly determine your success in the long run.
Certifi partners with benefits administrators to deliver automated premium billing and payment software that streamlines benefits billing and payment solutions for employers.
